And Then...There Was Life.
My first birth was scheduled during my fourth shift at the Riverside County Hospital. I was a second year nursing student doing my labor and delivery rotation during the hardest semester of my college career. Of course, school itself was challenging, but what made this semester the hardest was the effect it was having on my self confidence. I saw my colleagues stepping up to their tasks, being incredibly outspoken, and doing everything they could to gain valuable experience. They were quick and smart and sometimes it felt like I just couldn't compete. In my mind, I wasn't good enough; nursing was too hard, and I didn't know if I should be doing it at all. I began to doubt whether or not nursing was my calling. How are you supposed to be sure of that at twenty years old?
The format of our clinical rotations was two nursing students assigned to an experienced nurse at either a hospital or clinic. That day, I was paired with David, a fellow student who, at 39 years old, was the oldest student in our class. He also happened to be one of the most outspokenly smart students in the cohort. He was intelligent and fun to work with, so I was ok to be paired with him, but I just knew he was going to outshine me. We were assigned to Nurse Fallon, a notoriously stern nurse on the unit with a high working standard. She was the kind of mentor who would ask students questions and just expect them to know all the answers on the spot, or give us tasks and expect that we execute them whether we had done them before or not. Needless to say, between David and Nurse Fallon, I was feeling the pressure to perform.
Our patient was a woman named Shannon. Her labor began at around 7 A.M. and it took some time for her to progress. There wasn’t much for us to do through the early stages but to monitor, coach, and support the mother as she labored. Dilation progressed slowly but surely and it wasn’t until around 2 P.M. that things began to move more quickly. The patient had reached 10 centimeters and it was time for her to start pushing. The atmosphere of the room immediately changed and filled with personnel; everyone had their roles and everybody was busy preparing for the baby or tending to the mother. Nurse Fallon gave David some terse instructions which he handled easily. Then she turned to me and said, “Ok, take out the foley catheter.” I paled. I had never dealt with a foley catheter in my life. My heart began to race and I thought, Oh my god. What do I do? I walked over to the catheter but had to stop. I didn't know how to take it out! I didn’t want to do any harm to the mother. Nurse Fallon yelled, “Take it out, come on!” Seeing that I was lost, she pushed me to the side so she could begin to take it out herself. There is a balloon attached to the catheter that she deflated and then she called me back over to let me take out the rest with her supervision. I knew that she was just doing her job, and it was a high pace situation, but the chastisement stung. It didn’t help my internal dialog of feeling less than capable of being a nurse, but I had to keep working.
The next task was to get the patient into position in the stirrups. Nurse Fallon tasked me with raising the bed and positioning the mother on its edge. I raised the bed and began to place the mother’s feet into the stirrups, but she stumbled a bit because I wasn’t confidently supporting her. I found myself thinking, This lady doesn't even know me and I am going to ruin her birth experience!
Eventually, I was able to stabilize her and we moved her into position to start pushing. Nurse Fallon allowed David and I to be on either side of the mother’s legs, so we could have front row seats to the birth experience. David’s wife had actually recently had a child, so he was familiar with the process and was confident in taking initiative; he helped the mother breathe, he was counting for her, and he coached her through her contractions. Finally, after several minutes of pushing, the baby’s head became visible. At this point, the vagina doesn’t even look like a vagina anymore. It’s not uncomfortable. Everybody is past that at this point. With one labored push, amniotic fluid splashed all over David’s scrubs and just barely missed mine. The baby’s head pushed past the cervix and the body quickly followed. And then…there was life.
I cannot describe the feeling you get when you witness birth for the first time. It is one of the best feelings anyone can experience. A human just entered into the world. Life just started for someone. There is this moment once the baby is out into the world— there is this just this feeling. The mother was crying, the father was crying, and David and I were crying, too. I had just met the mother a few hours before, but somehow it felt like I had just experienced my own child being born.
Once the baby was out and everything began to settle, I had to walk out of the room. I stepped into the hall and quickly found a linen closet. I just needed to process what had happened. Also, I needed to cry. It was overwhelming partially because of how beautiful the moment was, but also because of how lousy I had been feeling the whole time. I felt so inadequate. I slumped down on the floor and put my head in my hands and let out the emotions I had done my best to hold in for the past several hours. Several minutes into my cry session, I remember hearing a gentle knock on the door. It was David.
“Hey, what’s wrong?” he asked.
“Dude,” I sighed, “You were kicking ass in there. You were amazing. I can’t be that great. I am never going to be as outspoken as you are. I don't know if I'm good enough or if this is even what I should be doing. This is way too hard. It’s so much harder than I thought it would be.”
David joined me on the floor, looked me in the eyes, and said, “Amber, you are way more qualified than I am to become a nurse. I’m about to be 40 years old! Do you think that I want to be a student at this point in my life? I have had so many different jobs and it has taken me so long to figure out what I want to do with my life. I’ve finally figured it out at 40 years old. But then I look at you, and all the other students in our cohort— you guys are just fresh out of high school and you already are on the right track. What an amazing opportunity that is! You didn't have to stumble through life to figure out that this is what you want to do. I understand that it's hard and I know how you’re feeling right now. Even though you might not think so, I feel the exact same way all the time. But you are more than capable of being a nurse, Amber. I don’t see you doing anything else.”
That is a day that I will always remember. Witnessing birth, the beginning of life, for the first time is an indescribable feeling. There is no way to capture it with words, you just have to experience it yourself. Now, years later, I work as a Registered Nurse in the Neonatal Intensive Care Unit. I have experienced many births since my first, and it is still always beautiful and emotional, but it will never compare to the first time. It is a uniquely special feeling. But I will also remember that day because of the open and raw conversation that I was able to have with my fellow nursing student. I will always remember the fear and insecurity that I felt on that day and the encouragement I received that helped me to move forward. For me, the significance of my first birth experience was twofold: I witnessed the beginning of a new life, but it was also a new beginning in mine.
Amber Arvizu, RN, BSN